| NPI | 1508479643 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACEY JO MONSON Billing/Contracts Administrator 530-245-5808 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator |
| 251B00000X Case Management | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness | |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| Enumeration Date | 2020-08-28 |
| Last Update Date | 2021-05-04 |